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VASCULAR ACCESS

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newlyfe's version from 2017-02-22 17:24

Section 1

Question Answer
WHAT ARE THE THREE MAIN TYPES OF ACCESSFISTULAS, GRAFTS AND CENTRAL VENOUS CATHETERS
ARTERIES CARRY OXYGEN RICH BLOOD FROM THE HEART AND LUNGS TO THE REST OF THE BODY
VEINS BRING OXYGEN POOR BLOOD BACK TO THE HEART AND LUNGS.
WHAT MAY A FISTULA BE REFERRED TO AS?A PERMANENT OR VENOUS ACCESS.
TO MAKE A GRAFT A SURGEON LINKS AN ARTERY AND VEIN EITH A PIECE OF SYNTHETIC (man made) BLOOD VESSEL.
CENTRAL VENOUS CATHERER IS A HOLLOW PLASTIC TUBE PLACED IN A DEEP CENTRAL VEIN IN THE CHEST OR LEG
WHAT TYPE OF ACCESS IS MOST LIKELY TO BECOME INFECTED?CATHETERS
HOW ARE FISTULA MADE?FROM THE PATIENTS OWN BLOOD VESSELS.
ARTERIALIZATION (AND WE SAY THE FISTULA IS MATURING)AS SOON AS THE SURGERY IS DONE STRONG FAST ARTERIAL BLOOD FLOW STARTS TO ENLARGE THE FISTULA AND MAKE IT TOUGHER.
WHAT IS THE MOST COMMAN UPPER ARE FISTULA?BRACHIOCEPHALIC
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Section 2

Question Answer
WHATS THE GOLD STANDARD FOR HD ACCESS?FISTULAS
WHATS THE MAIN CON TO OF A FISTULA?HOW LONG IT CAN TAKE TO MATURE 1-4 MONTHS.
WHAT TO LOOK FOR WITH NEW FISTULAS?SIGNS OF INFECTION (REDNESS DRAINAGE OR ABSCESS.) SIGNS OF WOUND HEALING OF THE INCISION
WHAT TO FEEL FOR ? THE THRILL, GROWTH IN THE VESSEL AND FIRMNESS OF THE VESSEL.
WHAT TO LISTEN FOR?A BRUIT. THE PITCH SHOULD BE LOW AND ONE SOUND SHOULD CONNECT TO THE NEXT
WHEN THE VESSEL HAS GROWN AND IS FIRM, WHAT WILL THE DOCTOR ORDER THE FISTULA TO BE?CANNULATED
CHECK THE DEPTH BY FEELING THE ENTIRE ACCESS. THE NEW FISTULA SHOULD BE NO DEEPER THAT _____ CM BELOW THE SKIN .6
CHECK THE DIAMETER BY PLACING THUMB AND FOREFINGER ON EACH SIDE OF THE NEW AVF. THE SIZE SHOULD EXCEED ______ CM .6
CHECK ACCESS BLOOD FLOW, SCHEDULE POST OP EVALUATION FROM A QUALIFIED PROVIDER TO VERIFY A MINIMUM FLOW OF ______ ML/MIN600
IF A LOCALIZED ACCESS INFECTION IS SUSPECTED AND IT HAS BEEN DERERMINED THAT THE ACCESS CAN BE CANNULATED, CANNULATION CAN ONLY BE PERFORMED IN AREAS THAT ARE NOT IN __________ PROMIMITY TO THE SITE OF SUSPECTED INFECTION. CLOSE
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Section 3

Question Answer
A FALSE ANEURYSM ASLO CALLED __________________ IS CHARACTERIZED BY BLOOD TRAPPED UNDER THE SKIN SURROUNDING AN AREA OF THE AVG. IT INDICATES GRAFT DAMAGE DUE TO REPEATED NEEDLE INSERTION INTO THE SAME AREA OF THE GRAFT WITHOUT ALLOWING FOR SUFFICIENT TIOME FOR OLD INSERTION SITES TO HEAL.PSEUDOANEURYSM
A POSSIBLE INTERVENTION FOR A VENOUS NEEDLE INFILTRATION THAT IS LOCALIZED AND NOT INCREASING IN SIZE OR SEVERITY IS TO CLAMP AND SECURE THE INFILTRATED NEEDLE AND TRCANNULATE THE ACCESS________THE INFILTRATE. ABOVE
TO PREVENT SKIN TEARS WHEN REMOVING TATPE YOU SHOULD HOLD THE SKIN AREA _______ TO THE TAPE WHEN REMOVING TAPE FROM FRAIL SKIN. CLOSE
WHEN HOLDING CANNULATION SITES POST TREATMENT ONE SHOULD WAIT AT LEAST ____________ MINUTES BEFORE CHECKING TO SEE IF BLEEDING HAS STOPPED 5-10
AFTER THE CANNULATION SITES HAVE STOPPED BLEEDING AND ARE DRESSED YOU SHOULD CHECK FOR THE PRESENCE OF THE BRUIT AND THRILL
A __________________ IS REQUIRED FOR UTILIZATION OF VASCULAR ACCESS CLAMPS PHYSICIAN ORDER
AFTER PLACEMENT OF A VASCULAR ACCESS CLAMP YOU MUST VERIFY THE PRESENCE OF THE THRILL AND BRUIT _________ AND ________ THE CLAMP TO PREVENT CLOTTING OF THE ACCESSABOVE BELOW
THE VASCULAR ACCESS CLAMP MAY REMAIN IN PLACE FOR _________ MINUTES BEFORE CHECKING TO SEE IF BLEED ING HAS STOPPED.5-10
PROLONGED BLEEDING OF CANNULATION SITES IS DEFINED AS BLEEDING MORE THEN _____ MINUTES POST NEEDLE REMOVAL. 30
HEMOSTATIC SPONGES SHOULD ONLY BE USED AFTER _________________HAS OCURRED DESPITE INTERVENTIONS LISTED IN P&P PROLONGED BLEEDING OF CANNULATION SITES. PROLONGED BLEEDING
ONCE BLEEDING HAS STOPPED HEMOSTATIC SPONGES ARE ______________SO THAT ANY REOCCURRENCE OF BLLEDING IS OBSERVED BY PATIENT CARE TEAMMATES. DISCARDED
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Section 4

Question Answer
CVC EXIT SITE DRESSINGS ARE CHANGED __________ DIALYSIS TREATMENT EVERY
THE CVC AND EXIT SITE MUST GBE EVALUATED ___________ TO THE INITIATION OF EVERY HEMODIALYSIS TREATMENTPRIOR
WHEN PERFORMING PRE AND POST DIALYSIS CVC CARE THE PATIENT SHOULD BE IN A ____________ POSITION TO INCREASE BLOOD FLOW THROUGH CVC AND DIMINISH RISK OF AIR EMBOLISM . SUPINE
THE RATIONALE FOR PATIENT AND TEAMMATE TO WEAR FACE MASKS COVERING NOSE AND MOUTH DURING A CVC PROCEDURE IS TO PREVENT ___________________________________________________SUCH AS MRSA. THE EXPOSURE OF THE CVC AND EXIT SITE TO NASAL DROPLETS AND INFECTIOUS BACTERIA
THE EXIT SITE IS CLEANED WITH 2% CHLORHEXIDINE GLUCONATE 70% ISOPROPYL ALCOHOL SWAB FOR A MINIMUM OF_______. AFTER CLEANING THE SITE YOU MUST WAIT FOR _______ FOR AIR DRY TIME . 30SEC 60SEC
WHEN YOU SCRUB THE HUB YOU MUST VERIFY THAT THE OPEN LUMEN IS NOT PLACED ON A __________________ SURFACE AND ____________ THE TIME ITIS OPEN . NON STERILE MINIMIZE
IF YOU MUST REVERSE THE LINES ON A CVC YOU SHOULD ONLY DO THAT FOR ______ TREATMENT AND NOTIFY THE NEPHROLOGIST OF THE ACCESS INSUFICIENCY ONE
THE LOCKING SOLUTION FOR CVCS WITH A TEGO CAP IS NORMAL SALINE.
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Section 5

Question Answer
WHEN CANNULATING A AVF/AVG THE NEEDLE TIPS SHOULD BE AT LEAST 2 INCHES APART
WHEN CANNULATION A AVF/AVG DO NOT INSERT THE NEEDLES CLOSER THAN 1.5 INCHES FROM THE ANASTOMOSIS
WHICH STATEMENT IS TRUE ABOUT POVIDONE LODINE?EFFECTIVE CONTACT TIME IS 30 SECONDS AND AIR DRYING TIME IS 2 MINUTES
AFTER ADMINISTERING THE HEPARIN BOLUS THROUGH THE VASCULAR ACCESS HOW LONG SHOULD YOU WAIT BEFORE INITIATING THE DIALYSIS TREATMENT ?5 MINUTES
WHICH STTEMENTS IS TRUE ABOUT THE INTRADERMAL ADMINISTRATION OF LIDOCAINE TO ANESTHETIZE CANNULATION SITE?ADMINISTRATION REQUIRES A SEPARATE SYRINGE FOR EACH SITE
WHICH STATEMENT IS TRUE REGARDING THE ADMINISTRATION OF PAIN EASE SPRAY PRIOR TO AVF/AVG CANNULATION?A CAN OF PAIN EASE SPRAY CAN BE USED ON DIFFERENT PATIENTS
PLACING THE ACCESS NEEDLES ONTO THE SAME CONFINED AREA TIME AFTER IS ALSO KNOWN AS ONE-SITE ITIS
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